New insights into the pathogenesis of Parkinson's disease (PD), the availability of a wider array of anti-parkinsonian therapies, the evolution of better tools for evaluating and monitoring disease progression have combined to change the current management of PD and the future landscape of PDrelated therapeutic clinical trials. This proposal outlines the key initial steps to develop the clinical trial methodology that allows for the longterm assessment of quality of life and economic outcomes in chronic neurological conditions. This will be accomplished by extending the duration of large multicenter clinical trial of pramipexole versus levodopa in early PD and augmenting the data collection effort to include clinical, quality of life, economic, and functional imaging outcomes. This will address questions for patients and providers on the best approach to treating early PD, as well as to provide a multidisciplinary research platform (clinical trials, quality of life assessment, and economic evaluation) to train a growing number of physician faculty and fellows at the University of Rochester in the theoretical, methodological, and practical knowledge and skills for a productive career in patient-oriented research. Dr. Holloway's position within the Departments of Neurology and Community and Preventive Medicine, and the Rochester Clinical Research Curriculum will ensure the recruitment of highly qualified trainees.